NORTHERN CALIFORNIA SOFT DRINK INDUSTRY AND TEAMSTERS HEALTH AND: Form 990, tax year 2020
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- Organization
- NORTHERN CALIFORNIA SOFT DRINK INDUSTRY AND TEAMSTERS HEALTH AND (EIN 94-6330971)
- Tax period
- 2020-11-01 to 2021-10-31
- Filed
- 2022-08-04
- IRS object ID
- 202242169349300224
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-04T10:13:26-05:00 | ReturnTs |
| Tax Period End | 2021-10-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 542189926 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Henningfield & Associates Inc | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28296 Constellation Road | AddressLine1Txt |
| City | Valencia | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-11-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 946330971 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN CALIFORNIA SOFT DRINK INDUSTRY | BusinessNameLine1Txt |
| Business Name Line2 | & TEAMSTERS HEALTH AND WELFARE TRUST FND | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 9258334353 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4160 DUBLIN BLVD No 400 | AddressLine1Txt |
| City | DUBLIN | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94568 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DENNIS HART | PersonNm |
| Person Title | TRUSTEE | PersonTitleTxt |
| Phone | 9258334353 | PhoneNum |
| Signature | 2022-08-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DENNIS | PersonFirstNm |
| Person Last | HART | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RANDY D HENNINGFIELD | PreparerPersonNm |
| PTIN | P01364367 | PTIN |
| Phone | 6612953363 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DENNIS HART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7750 PARDEE LANE | AddressLine1Txt |
| City | OAKLAND | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94621 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,902,527 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,332,549 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,927,303 | CYProgramServiceRevenueAmt |
| PY Investment Income | $513,517 | PYInvestmentIncomeAmt |
| CY Investment Income | $825,591 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $1,991,428 | CYOtherRevenueAmt |
| PY Total Revenue | $10,846,066 | PYTotalRevenueAmt |
| CY Total Revenue | $17,744,322 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $13,042,891 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $14,731,967 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $848,128 | PYOtherExpensesAmt |
| CY Other Expenses | $920,856 | CYOtherExpensesAmt |
| PY Total Expenses | $13,891,019 | PYTotalExpensesAmt |
| CY Total Expenses | $15,652,823 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,044,953 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,091,499 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,415,644 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,333,811 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $40,776 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,566 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,374,868 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,318,245 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNION AND EMPLOYERS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,652,823 | ExpenseAmt |
| Desc | TO PROVIDE HEALTH AND WELFARE BENEFITS TO ELIGIBLE PARTICIPANTS COVERED UNDER COLLECTIVE BARGAINING AGREEMENTS BETWEEN THE UNION AND EMPLOYERS. | Desc |
| Total Program Service Expenses | $15,652,823 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MR MATT CLIZBE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9258334353 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4160 DUBLIN BLVD SUITE 400 | AddressLine1Txt |
| City | DUBLIN | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94568 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| JEFF CARLSEN | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| CHRIS LOPEZ | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| PENNY SCHUMACHER | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| ROBIN USSERY | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| JESSE CASQUEIRO | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| DENNIS HART | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| MARK HAWKINS | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| BRIAN INDELICATO | |||||
| TRUSTEE | 5.00 | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HEALTH SERVICES & BENEFIT ADMINISTRATORS | |||||
| 4160 DUBLIN BLVD STE 400 | DUBLIN | CA | 94568 | ADMINISTRATOR | $247,200 |
| SEYFARTH SHAW | |||||
| 2029 CENTURY PARK EAST STE 3500 | LOS ANGELES | CA | 90067 | LEGAL | $149,914 |
| ANTHEM BLUE CROSS | |||||
| 11050 OLSON DRIVE STE 110 | RANCHO CORDOVA | CA | 95670 | CLAIMS ADMINISTRATOR | $134,575 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| EMPLOYER CONTRIBUTIONS | 900099 | $14,899,200 | $14,899,200 |
| PARTICIPANT CONTRIBUTIONS | 900099 | $28,103 | $28,103 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,927,303 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $316,260 | TotalRevenueColumnAmt |
| Exclusion | $316,260 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,667,536 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $18,158,205 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $509,331 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $509,331 | TotalRevenueColumnAmt |
| Exclusion | $509,331 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| STOP LOSS RECOVERIES | 900099 | $1,527,575 | $1,527,575 |
| PRESCRIPTION DRUG REBATES | 900099 | $455,636 | $455,636 |
| COBRA SUBSIDY | 900099 | $8,217 | $8,217 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,991,428 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,744,322 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,918,731 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $825,591 | ExclusionAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,731,967 | TotalAmt |
| Program Services | $14,731,967 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,200 | TotalAmt |
| Program Services | $247,200 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,889 | TotalAmt |
| Program Services | $219,889 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,720 | TotalAmt |
| Program Services | $17,720 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,995 | TotalAmt |
| Program Services | $91,995 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,500 | TotalAmt |
| Program Services | $27,500 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,550 | TotalAmt |
| Program Services | $9,550 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,317 | TotalAmt |
| Program Services | $1,317 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,698 | TotalAmt |
| Program Services | $18,698 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| ANTHEM BLUE CROSS | $124,255 | $124,255 |
| BENEFIT CONSULTANTS | $94,842 | $94,842 |
| T.A.P. PROGRAM | $21,097 | $21,097 |
| PRINTING AND POSTAGE | $13,541 | $13,541 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,252 | TotalAmt |
| Program Services | $33,252 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,652,823 | TotalAmt |
| Program Services | $15,652,823 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,162,816 | BOYAmt |
| EOY | $2,663,245 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,916,816 | BOYAmt |
| EOY | $1,502,345 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,265 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,334,747 | BOYAmt |
| EOY | $15,168,221 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,415,644 | BOYAmt |
| EOY | $19,333,811 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,776 | BOYAmt |
| EOY | $15,566 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,776 | BOYAmt |
| EOY | $15,566 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,374,868 | BOYAmt |
| EOY | $19,318,245 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,374,868 | BOYAmt |
| EOY | $19,318,245 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,415,644 | BOYAmt |
| EOY | $19,333,811 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,091,499 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$148,122 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $17,504,205 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$148,122 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$148,122 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,652,327 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $91,995 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $91,995 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,744,322 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,560,828 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $15,560,828 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $91,995 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $91,995 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,652,823 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The trust has adopted guidance on accounting for uncertainty in income taxes issued by the Financial Accounting Standards Board. The Trust's management believes that the trust has not taken certain tax positions that require adjustment to the financial statements as a tax liability. Informational tax returns, for tax years for which the applicable statutes of limitations have not expired, are subject to examiniation by authorities. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | The organization has delegated control over management duties customarily performed by or under the direct supervision of officers, directors, trustees, or key employees to a contract administrator, Health Services & Benefit Administrators. |
| Form 990, Part VI, Section A, line 8b | The organization does not have sub-committees with the authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | Trustees are emailed the form and asked to remark if they have changes. |
| Form 990, Part VI, Section B, line 12c | Trustees review & re-sign the policy annually. |
| Form 990, Part VI, Section C, line 19 | The organication makes its governing document, conflict of interest policy, and financial statements available to the public upon request. Summary Annual Reports are provided to all participants annually. SPD's and audited financial statements are available from the administrator upon request, as well as the DOL website. |
| Form 990, Part VII Contact Addresses for Officers, Directors, Etc | JEFF CARLSEN - 6250 N. RIVER ROAD, STE 9000, ROSEMONT, IL 60018. CHRIS LOPEZ - 1300 W. TAFT AVENUE, ORANGE, CA 92865. PENNY SCHUMACHER - 5918 STONERIDGE MALL, PLEASANTON, CA 94588. ROBIN USSERY - 6250 N. RIVER ROAD, STE 9000, ROSEMONT, IL 60018. JESSE CASQUEIRO - 7750 PARDEE LANE, OAKLAND, CA 94621. DENNIS HART - 7750 PARDEE LANE, OAKLAND, CA 94621. MARK HAWKINS - 400 ROLAND WAY, OAKLAND, CA 94621. BRIAN INDELICATO - 301 GEORGIA STREET, STE 220, VALLEJO, CA 94590. |
| Form 990, Part XII, Line 2c: | The Board of Trustees assumes responsibility for the oversight of the audit of the organization's financial statements and the selection of independent auditor. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| TEAMSTERS LOCAL 853 | ||||||||
| 7750 PARDEE LANE | OAKLAND | CA | 94621 | 940963930 | LABOR UNION | CA | 501(C)(5) | 0 |
| TEAMSTERS LOCAL 70 | ||||||||
| 400 ROLAND WAY | OAKLAND | CA | 94621 | LABOR UNION | CA | 501(C)(5) | 0 | |
| TEAMSTERS LOCAL 896 | ||||||||
| 301 GEORGIA STREET STE 220 | VALLEJO | CA | 94590 | 951498604 | LABOR UNION | CA | 501(C)(5) | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|
| REYES HOLDINGS LLC | ||||||||
| 6250 N RIVER ROAD STE 9000 | ROSEMONT | IL | 60018 | 364121934 | BEVERAGE DISTRIBUTION | IL | C | 0 |
| KEURIG DR PEPPER | ||||||||
| 1300 W TAFT AVENUE | ORANGE | CA | 92865 | BEVERAGE DISTRIBUTION | CA | C | 0 | |
| SAFEWAY NORTHERN CALIFORNIA DIVISION | ||||||||
| 5918 STONERIDGE MALL | PLEASANTON | CA | 94588 | BEVERAGE DISTRIBUTION | CA | C | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |